Recommendation ID
NICE encourages further research into CXL using riboflavin and UVA for keratoconus and keratectasia, especially epithelium-on (transepithelial) CXL and the combination (CXL-plus) procedures. Details of the techniques used should be clearly described. Reported outcomes should include visual acuity, corneal topography and quality of life. Data on long-term outcomes for all types of CXL using riboflavin and UVA for keratoconus and keratectasia would be useful – specifically data about prevention of progression to corneal transplantation and about repeat procedures and their efficacy.
Any explanatory notes
(if applicable)
Current evidence on the safety and efficacy of epithelium-on (transepithelial) CXL, and the combination (CXL-plus) procedures for keratoconus and keratectasia is inadequate in quantity and quality. Therefore, these procedures should only be used with special arrangements for clinical governance, consent and audit or research.

Source guidance details

Comes from guidance
Photochemical corneal collagen cross‑linkage using riboflavin and ultraviolet A for keratoconus and keratectasia
Date issued
September 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 08/10/2013